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<br />I
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<br />88--...101984
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<br />WHEN THIS COpy CARRIES THE RAISED SEAL OF THE NEBRASKA STATE
<br />DEPARTMENT OF HEALTH. IT CERTIFIES THE BELOW TO BEA-,TRUE COPY
<br />OF AN ORIGINAL RECORD ON FILE wITH THE STATE DE~~jA~~V9~.,.H~LTH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEG~L\-1?W?P9I:rO,~"i.~9!t
<br />VITAL RECORDS. ' /':'.' ; / l' ,\..\ ':'"..f..'
<br />
<br />j.k~jj~~~('~ 1 ~~:~ "r
<br />DATE OF ISSUANCE /J1~t(r \f.:4l.v.rr:~. ;'
<br />DEe:3 1981 STANLEy~i:', GOOPER;:.o.ialtToR
<br />" {. " """,' " :'-,":'
<br />
<br />LINCOLN. NEBRASKA BUREAU 6p..~~'~~~STICS
<br />
<br />" 'I, 'I, 1" ,....... ,.~
<br />
<br />EXHIBIT A
<br />
<br />DlCeDetolT NAAlf
<br />
<br />
<br />IUT
<br />
<br />STATE Of NEIltASKA-DEf'UTMENT OF HlAlTM
<br />BUREAU OF VITAL STATISTICS
<br />CERTIFICATE OF DEATH LAj.
<br />MIOOU
<br />
<br />IJ HQ$.P- 0. ~...u_ illldiclilht 00....
<br />O"........i.,,'/i!... .... ...pati..... tJ-PKrl,J
<br />
<br />14.. Grand Island
<br />IUll:lEMCe -STAff COUtolTY
<br />
<br />
<br />Ulo. Hall
<br />
<br />MI
<br />
<br />.. . August C.
<br />WAS DlceASeD fYel ItoI U.S, AIMIO FQlCIS?
<br />(Yft. ..~ _ .-U I (:If .,..... gi.. -.. etld de,," of MhIC.~
<br />'1, Yes: 4-14-45 8-15-46
<br />IUIIAL C._loft, 1._llIAJ
<br />
<br />Wichman Carrie
<br />IHfOltlMtoIT - NAMf - ULAnONSH" -MAILING AD:lIESS
<br />
<br />UKN Obermiller
<br />t"IU! 01 "' D NO. Cln 01 tOWN. ~t"n. 1"1
<br />
<br />
<br />If, Edith lUchman Wife
<br />CeMElflY 01 elfMAJOlT toIAA1f
<br />
<br />
<br />NE. 68803
<br />CITY OtTOWN STAff
<br />
<br />21, 1987 ZOc. Grand Island Cit'
<br />:l'l J 0 fUNllAL H()hlf - NAAlf AtoID AODIfSS
<br />
<br />22, Apfel-Butler-Geddes, 1123 W. 2nd, G.!., NE.. 68803
<br />DAn SIGtoIfo IMo. D"r. Y,,) HOUIOI DfATH
<br />
<br />2.b. Ii<
<br />'IONOUNCfD Of AD (Ho..)
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<br />
<br />'-
<br />
<br />Dr. David
<br />ItGlSJIAII
<br />
<br />NE. 68901
<br />
<br />DAn UCflVfO BY If GiSt..... (114.., D.r. Y,.I
<br />NOV 2 5 \987
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